Ileal Pouch-Anal Anastomosis-A Surgical Perspective

Despite aggressive medical management, approximately 50% of patients with inflammatory bowel disease will require surgery during the clinical course of their disease. For ulcerative colitis, surgery offers the chance for cure, with ileal pouch anal anastomosis as the procedure of choice in elective cases. In this article, we review the development, indications, and recent advances in ileal pouch anal anastomosis surgery and the remaining controversies regarding surgical technique and staging of surgery in the modern era of biological medical therapy. (C) 2012 Elsevier Inc. All rights reserved.